High Blood Pressure (Hypertension)

What is high blood pressure (Hypertension)

High blood pressure (hbp) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high. You can have high blood pressure (hypertension) for years without a single symptom. But silence isn't golden. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

Hypertension can be classified as either essential (primary) or secondary. Essential hypertension indicates that no specific medical cause can be found to explain a patient's condition. Secondary hypertension indicates that the high blood pressure is a result of (i.e., secondary to) another condition, such as kidney disease or tumors (pheochromocytoma and paraganglioma). Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure. Even moderate elevation of arterial blood pressure leads to shortened life expectancy. At severely high pressures, defined as mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.
Arteriosclerosis is hardening of the arteries. The walls of arteries have a layer of muscle and elastic tissue that makes them flexible and able to dilate and constrict as blood flows through them. High blood pressure can make the artery walls thicken and harden. When artery walls thicken, the inside of the blood vessel narrows. Cholesterol and fats are more likely to build up on the walls of damaged arteries, making them even narrower. Blood clots also can get trapped in narrowed arteries, blocking the flow of blood.
Arteries narrowed by arteriosclerosis may not deliver enough blood to organs and other tissues. Reduced or blocked blood flow to the heart can cause a heart attack. If an artery to the brain is blocked, a stroke can result.
Hypertension makes the heart work harder to pump blood through the body. The extra workload can make the heart muscle thicken and stretch. When the heart becomes too enlarged it cannot pump enough blood. If the hypertension is not treated, the heart may fail.
The kidneys remove the body's wastes from the blood. If hypertension thickens the arteries to the kidneys, less waste can be filtered from the blood. As the condition worsens, the kidneys fail and wastes build up in the blood. Dialysis or a kidney transplant are needed when the kidneys fail. About 25% of people who receive kidney dialysis have kidney failure caused by hypertension.

Blood pressure measurements are classified in stages, according to severity:

1. Normal blood pressure: less than less than 120/80 mm Hg
2. Pre-hypertension: 120-129/80-89 mm Hg
3. Stage 1 hypertension: 140-159/90-99 mm Hg
4. Stage 2 hypertension: at or greater than 160-179/100-109 mm Hg

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Signs and symptoms High Blood Pressure (Hypertension)

Hypertension is often confused with mental tension, stress and anxiety. While chronic anxiety and/or irritability is associated with poor outcomes in people with hypertension, it alone does not cause it. Accelerated hypertension is associated with somnolence, confusion, visual disturbances, and nausea and vomiting (hypertensive encephalopathy).
Hypertension is usually found incidentally "case finding" by healthcare professionals during a routine checkup. The only test for hypertension is a blood pressure measurement. Hypertension in isolation usually produces no symptoms although some people report headaches, fatigue, dizziness, blurred vision, facial flushing, transient insomnia or difficulty sleeping due to feeling hot or flushed, and tinnitus during beginning onset or prior to hypertention diagnosis.
Malignant hypertension (or accelerated hypertension) is distinct as a late phase in the condition, and may present with headaches, blurred vision and end-organ damage.

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Causes High Blood Pressure (Hypertension)

When a person has hypertension caused by another medical condition, it is called secondary hypertension. Secondary hypertension can be caused by a number of different illnesses. Many people with kidney disorders have secondary hypertension. The kidneys regulate the balance of salt and water in the body. If the kidneys cannot rid the body of excess salt and water, blood pressure goes up. Kidney infections, a narrowing of the arteries that carry blood to the kidneys, called renal artery stenosis, and other kidney disorders can disturb the salt and water balance.

Cushing's syndrome and tumors of the pituitary and adrenal glands often increase levels of the adrenal gland hormones cortisol, adrenalin, and aldosterone, which can cause hypertension. Other conditions that can cause hypertension are blood vessel diseases, thyroid gland disorders, some prescribed drugs, alcoholism, and pregnancy.
Even though the cause of most hypertension is not known, some people have risk factors that give them a greater chance of getting hypertension. Many of these risk factors can be changed to lower the chance of developing hypertension or as part of a treatment program to lower blood pressure.
Certain medications including birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs also may cause secondary hypertension. In a 2005 study, women who took an average of 500 milligrams or more of acetaminophen (Tylenol, others) daily over several years were more likely to develop high blood pressure than were women who didn't take any acetaminophen. It's not known if the same holds true for men.
Various illicit drugs, including cocaine and amphetamines, also can increase blood pressure.

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Risk factors High Blood Pressure (Hypertension)

1. Family history, High blood pressure tends to run in families.
2. Race, High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites.
3. Age, The risk of high blood pressure increases as you get older.
4. Stress. High levels of stress can lead to a temporary but dramatic increase in blood pressure.
5. Excessive alcohol. Over time, heavy drinking can damage your heart.
6. Sodium intake. Too much sodium in your diet especially if you have sodium sensitivity can lead to fluid retention and increased blood pressure.
7. Low potassium intake. Potassium helps balance the amount of sodium in your cells.
8. Tobacco use. The chemicals in tobacco can damage the lining of your artery walls, which promotes narrowing of the arteries.
9. Excess weight. The greater your body mass, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
10. Inactivity. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
    

Complications High Blood Pressure (Hypertension)
Uncontrolled high blood pressure can lead to:

1. Heart failure
2. Thickened, narrowed or torn blood vessels in the eyes
3. Weakened and narrowed blood vessels in the kidneys
4. A blocked or ruptured blood vessel in the brain
5. Damage to the arteries
6. Metabolic syndrome

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Treatment High Blood Pressure (Hypertension)

Changing your lifestyle can go a long way toward controlling high blood pressure. But sometimes lifestyle changes aren't enough. In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure. Which category of medication your doctor prescribes depends on your stage of high blood pressure and whether you also have other medical conditions. Lifestyle changes that may reduce blood pressure by about 5 to 10 mm Hg include:

1. Reducing salt intake
2. Reducing fat intake
3. Losing weight
4. Getting regular exercise
5. Quitting smoking
6. Reducing alcohol consumption
7. Managing stress
   

The major types of medication used to control high blood pressure include:

1. Thiazide diuretics
2. Renin inhibitors
3. Calcium channel blockers
4. Angiotensin II receptor blockers
5. Angiotensin-converting enzyme (ACE) inhibitors
6. Beta blockers
7. Alpha blockers
8. Central-acting agents
9. Vasodilators
10. Alpha-beta blockers

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Capoten

Generic Name: captopril
Brand Names: Capoten

What is Capoten
Captopril is used to treat high blood pressure and heart failure. It decreases certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.
Capoten is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Dosage Capoten
Captopril is available with a prescription under the brand name Capoten. Other brand or generic formulations may also be available.

1. Capoten 12.5 mg - oval, white tablets
2. Capoten 25 mg - rounded, square, white tablets
3. Capoten 50 mg - oval, white tablets
4. Capoten 100 mg - oval, white tablets
   

Side effects Capoten

1. Cough
2. Loss of taste sensation, loss of appetite
3. Dizziness, drowsiness, headache
4. Sleep problems (insomnia)
5. Dry mouth, sores in the mouth or on the lips
6. Nausea, diarrhea, constipation
7. Mild skin itching or rash
8. Feeling light-headed, fainting
9. Urinating more or less than usual, or not at all
10. Fever, chills, body aches, flu symptoms
11. Pale skin, easy bruising or bleeding
12. Fast, pounding, or uneven heartbeats
13. Chest pain
14. Swelling, rapid weight gain

DRUG INTERACTIONS: Before using this medication, tell your doctor of all prescription and nonprescription products you may use, especially of: drugs that suppress the immune system (e.g., azathioprine), other heart drugs (e.g., digoxin), other high blood pressure medications, lithium, non-steroidal anti-inflammatory drugs (NSAIDS such as celecoxib, ibuprofen, indomethacin), potassium-sparing "water pills" (diuretics such as amiloride, spironolactone, triamterene), potassium supplements (e.g., potassium chloride) or salt substitutes, trimethoprim-containing medications (e.g., sulfamethoxazole/trimethoprim), "water pills" (diuretics such as furosemide). Check the labels on all your medicines (e.g., cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate or blood pressure.

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